Heel spur
Heel spur
A heel spur is caused by one-sided overloading, excess weight or misalignment. The result is a bony, thorn-like outgrowth of bone on the heel bone. In the area of the tendon insertion, there are minor injuries in a heel spur, which calcify and are accompanied by an inflammatory reaction. This causes the actual pain, not the bony outgrowth itself.
Heel spur: when every step hurts
Anyone who has ever had heel pain when walking knows how terrible it can be. It is a sudden, burning pain that increases throughout the day. In addition to rheumatic joint inflammation, the cause of this discomfort is often a heel spur.
This is a thorn-like bony outgrowth on the underside of the heel bone. The bony change is not very large (between 1 and 15 mm) and is present in around 10% of the population. However, heel spurs only cause pain in a small number of people. The type, intensity and frequency of this pain can vary greatly. In most cases, the pain is stabbing or burning – as if you were stepping on a nail. Women are affected more often than men. The average age at which heel spurs occur is around 50 to 60 years of age.
Over decades, the longitudinal arch of the foot flattens, causing the plantar fascia to come under tension. This tensile load on the heel bone via the tendons and connective tissue that attach to the bone can cause the heel spur.
This is because the body tries to counteract the excessive strain: it deposits calcium – in the form of small “thorns” – at the affected tendon insertions to provide more stability.
For clarification:
The plantar fascia – a broad, flat tendon – runs under the sole from the midfoot to the heel bone. If the tendon is under too much tension, e.g. due to excess weight or sporting activity, tiny tears can occur at the attachment of the tendon to the heel bone. These subsequently lead to local inflammation and tissue changes. The body deposits calcium in these tears as a kind of repair attempt, which grows into a heel spur.
What are the symptoms of heel spurs?
The typical knife-like, severe pain under the heel or on the inside of the heel initially only occurs sporadically and during and after exertion. In the advanced stage of the heel spur, any strain on the foot is associated with pain. In the acute stage, the pain can be so extreme that walking becomes almost impossible.
How is a heel spur diagnosed?
Severe localized pain is already a good diagnostic indication of the disease. An X-ray or ultrasound examination of the calcaneus is often sufficient to confirm the diagnosis. Magnetic resonance imaging is only rarely necessary.
What is the treatment for heel spurs?
As an orthopaedist Münster we at Z.O.R. am Roggenmarkt offer you various therapies to treat your heel spur. First of all, the load must be reduced. Avoiding compressive loads, such as when jogging, is the first priority. Any excess weight should be reduced at the same time. The foot should be supported by the insole, which is made according to an exact footprint. In the area of the heel spur, soft bedding is also worked into the insole. Warm foot bands, stretching and strengthening exercises and special massage often help. If these measures are unsuccessful, medication and injections are used. A cortisone preparation is usually used here.
The next treatment step if drug treatment fails is shock wave therapy. This involves injecting short pulses of very high energy directly into the affected area of the body via the skin. This shatters the calcium deposits and reduces inflammatory reactions. Approximately 2,000 shock waves are delivered per treatment. Three to five treatments are usually required at intervals of 7-14 days.
We carry out the treatment as your orthopaedist Münster at the Z.O.R. at Roggenmarkt on an outpatient basis. It only takes a few minutes and can be easily combined with other measures. Numerous studies have demonstrated the excellent effectiveness of shockwave therapy for heel spurs. In addition, shock wave therapy causes practically no downtime due to illness. The most important thing for patients, however, is that they not only avoid a stay in hospital, but also the considerable risks of anesthesia and surgery.
Since shock wave therapy has found its way into orthopaedics, surgery is only necessary in a few cases. During surgery, the heel spur is chiseled off and a narrow strip of plantar fascia is removed. In recent years, endoscopic procedures have been increasingly used, which are much gentler and less risky.
Preventing heel spurs
Being overweight is a risk factor for many diseases, some of which are life-threatening, but also for heel spurs. Losing weight is therefore very sensible. Sporting activity must not lead to pain. You should therefore not forget to warm up and stretch before any sporting activity. If heel pain occurs, do not do any sport for as long as the pain persists. Well-fitting shoes are important for both leisure and work. Good cushioning under the heel and heel support are very important in this context.
Ideally, you should buy a running shoe after checking your rolling motion on the treadmill (good running shoe stores can be recognized by this). Ideally, insoles should also be inserted after a computerized foot pressure analysis. In the case of existing foot misalignments, specialist medical advice and treatment are always advisable.
Don’t bother with a heel spur. We use cause-oriented therapies to quickly alleviate your symptoms. Book your appointment now at Z.O.R. am Roggenmarkt online or by calling
on 0251 603-23 or 20251 603-24.